April 2010

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Medical conditions as seen in the movies

in Potpourri | 5 responses

by Vineet Arora, MDI recently went to see Alice in Wonderland in 3D.This epic creation by part genius–part disturbed director Tim Burton features the wickedly talented method actor Johnny Depp as the ‘Mad Hatter.’  As I was watching Johnny Depp’s orange hair and freakish eyes, it occurred to me that some of the most popular fiction movies over the last several years have featured some notable legends ...

Diet pills can be dangerous and should be used with caution

in Meds | one response

by Kristina FioreDiet pills that are adulterated with undeclared pharmaceutical ingredients can be addictive, researchers say.In a case report, a 29-year-old female patient became addicted to Brazilian diet pills that contained unlabeled ingredients, and suffered subsequent psychiatric comorbidities, Benjamin R. Smith, BS, and Pieter A. Cohen, MD, of Harvard Medical School reported in The American Journal on Addictions."Given the rising prevalence of adulterated diet pills, increasing awareness among clinicians of ...

Op-ed: Health reform is missing malpractice and primary care fixes

in Policy | 34 responses

The following op-ed was published on March 22nd, 2010 in CNN.com.With health reform passing the House, a comprehensive overhaul of our health care system draws another step closer.Coverage will expand to cover nearly 95 percent of legal U.S. residents. With a recent study showing that patients without health insurance have a shorter life span, coupled with the number of uninsured approaching 50 million in 2010, that is perhaps the ...

Salaried physicians become more politically progressive

in Policy | 25 responses

by Danielle Ofri, MD, PhDA recent article in the New York Times noted a steady migration of doctors from private practice to hospital-owned health systems. The main driving force appears to be economic, that it is too difficult to run a business, especially when much of that entails fighting multiple insurance companies for reimbursement.Some of the older physicians interviewed expressed “puzzlement” at younger doctors who chose salaried positions rather than ...

Health costs are high, and here’s why

by | in Physician | 16 responses

Health costs are high because the body is complicated and doctors and patients hate ambiguity. The cost is high because a missed diagnosis can lead to death and a large lawsuit. The cost is high because we have many specialists that view the body in tiny pieces and want to feel 100% correct about their piece.Let me give you a real life example.My patient, Rick, is a brilliant attorney. He ...

Breastfeeding rates cost the country billions

in Physician | 11 responses

by Crystal PhendPoor compliance with breastfeeding recommendations costs the nation at least $13 billion each year, with nearly all of the cost related to infant morbidity and mortality, according to a comprehensive economic analysis.If 90% of new mothers followed guidelines for six months of exclusive breastfeeding for their children, an estimated 911 deaths would be prevented annually, said authors Melissa Bartick, MD, MSc, of Harvard Medical School, and Arnold Reinhold, ...

Health care cost control requires saying no to patients

in Policy | 11 responses

Let's face it, the best way to cut health costs is to say "no."That means denying unnecessary tests that most patients in the United States are accustomed to having.The New York Times' David Leonhardt has the best take on this issue that I've read. He acknowledges the difficulty of telling the American public "no," and cites examples ranging from the breast cancer screening controversy to the managed care ...

Physicians are leaving medicine for alternative careers

by | in Physician | 7 responses

When physicians choose to leave clinical medicine to pursue alternative careers, what motivates them to make such changes? Is it money? More time with family? Scheduling flexibility? Avoiding litigation? To pursue new challenges? Maybe you're getting bored with medicine.Depending on that key motivating factor, physicians end up choosing all types of career paths. For instance, let's take a look at some of these motivators:Money. Let's face it. Some physicians love ...

Checklists help reduce hospital deaths

in Physician | 3 responses

by Michael SmithThe use of treatment checklists for 13 common diagnoses was associated with a dramatic reduction in patient deaths at three London hospitals, researchers said.The year the checklists were introduced, the three facilities in the North West London Hospitals NHS Trust registered 255 fewer deaths than the previous year, according to Brian Jarman, PhD, of Imperial College London, and colleagues.The targeted diagnoses accounted for 174 fewer deaths than the ...

Primary care and the three year medical student

in Physician | 28 responses

It's well documented on this blog that the primary care shortage will only worsen once most of America has access to affordable health insurance.As I wrote in a recent op-ed. not only will there a shortage of primary care physicians, but nurse practitioners and physician assistants won't alleviate the problem either, mostly because they are also enticed by the lucrative allure of specialty practice.Enter the three-year primary care ...

Primary care doctors are saying farewell

in Physician | 16 responses

by Aldebra Schroll, MDIt has been three months since I closed the door on my primary care office for the last time. It was with a heavy heart that I said goodbye to the many patients I cared for over the last six years. I am the fourth physician to leave the practice in as many years.As the economy faltered, I found my private office practice had simply become unsustainable. ...

Rural medicine won’t be helped by health reform

in Physician | 11 responses

by Rick Bendinger, MDI am a rural health provider in Abbeville, Alabama and have been here almost 30 years. I originally went to school on a public health scholarship and took the private practice option. This was a program that existed in the 1980s that paid for tuition and a stipend with the obligation to go either to a prison, rural area, or Indian reservation.Sadly the program no longer exists. ...

Patients who visit the emergency department have insurance

in Policy | one response

by Joyce FriedenMost patients who visit the emergency department (ED) four or more times a year have health insurance and a primary care physician, a review of the literature found."The uninsured represent only 15% of frequent users and are no more likely to be frequent users than they are to be occasional ED users (<4 visits/year)," Eduardo LaCalle, MD, MPH and Elaine Rabin, MD, of the Mount Sinai School of ...

Private practice medicine will soon become extinct

in Physician | 30 responses

I've written previously that the days of the private practice physician are numbered.A detailed piece from the New York Times confirms the exodus.Young doctors, who are burdened with medical school debt exceeding $150,000 are opting for the financial stability that a salary from a hospital-owned practice, or a large integrative medical center, can bring. Gone are the days where a solo practitioner can hang a shingle and ...

Patient stories on the web may not be real

by | in Patient | one response

"On the Internet, nobody knows you’re a dog” was the caption of the famous cartoon by Peter Steiner in the July 5, 1993 issue of The New Yorker. The same is true of patient stories on health Web sites: nobody knows who really wrote them.In the case of Lifestyle Lift, the company agreed to pay a $300,000 settlement last year to New York State because their patient stories were employee-generated.Patient ...

Price transparency will improve patient care

in Patient | 12 responses

by Leslie Ramirez, MDDebora T. had a blood pressure of 180/110 during her routine visit in my internal medicine clinic. She was already on every blood pressure medication I could think of, save one -- amlodipine. I prescribed the medicine and asked her to follow up in a week. I feared her blood pressure was going to cause a stroke if it went up any higher.At our next visit, her ...

Healthcare workers in the ER hit hard by H1N1

in Physician | no responses

by Michael SmithHealthcare workers in a New York City emergency department had the highest rate of infection among employees of an urban hospital system during the first wave of the H1N1 pandemic flu, researchers said.In a single-institution study using medical and administrative records, the adult emergency department had an H1N1 infection rate of 28.8% during April, May, and June of 2009, according to Robert Bristow, MD, and colleagues at New ...

Real world meaningful use of health IT for physicians

in Tech | 6 responses

by David C. Kibbe, MD, MBAAn article in the April 10, 2010 New York Times entitled "Doctors and Patients, Lost in Paperwork," brought attention to what may be, in the near term, the Achilles heel of the plan to incentivize doctors for the "meaningful use of EHR technology."The article cited a study published in the Archives of Internal Medicine this past February, which asked a large cohort of physicians in ...

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